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MR imaging of the reconstructed breast: What the radiologist needs to know.

Dialani V, Lai KC, Slanetz PJ - Insights Imaging (2012)

Bottom Line: Surgical management of breast cancer often entails lumpectomy or mastectomy.In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps.Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, C/o Dr. Vandana Dialani, 330 Brookline Avenue, Boston, MA, 02215, USA, vdialani@bidmc.harvard.edu.

ABSTRACT

Objective: The objective is to review the different types of breast reconstruction following cancer surgery and describe expected imaging appearances and complications seen in the reconstructed breast.

Methods: Surgical management of breast cancer often entails lumpectomy or mastectomy. When mastectomy is performed, patients often opt for breast reconstruction. Most facilities do not routinely image the reconstructed breast with mammography.

Results: However, many of these women are imaged with screening breast MRI for evaluation of the contralateral breast, or they may develop a clinical problem that warrants a diagnostic evaluation with MRI. In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps. Each of these types of reconstruction has different appearances on MR. We will also discuss potential complications that can be seen in the reconstructed breasts, including fat necrosis and recurrence.

Conclusion: Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI. Radiologists will be more aware of how to recognize complications related to surgery as well as how to determine whether recurrence is present.

Main messages: • The different surgical techniques used in breast reconstruction are discussed. • Describes the normal magnetic resonance imaging appearance of the breast after reconstruction. • Identify MR imaging features of benign sequelae and recurrence following breast reconstruction.

No MeSH data available.


Related in: MedlinePlus

A 57-year-old woman status post left mastectomy and latissimus dorsi myocutaneous flap reconstruction 12 years prior for diffuse DCIS. Enhanced T1W image demonstrates a 7-mm enhancing mass (arrow) in the posterior, lateral reconstructed left breast. This area was subsequently biopsied under ultrasound guidance with pathology demonstrating invasive carcinoma with ductal and lobular features involving fibro-adipose tissue and skeletal muscle
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Fig11: A 57-year-old woman status post left mastectomy and latissimus dorsi myocutaneous flap reconstruction 12 years prior for diffuse DCIS. Enhanced T1W image demonstrates a 7-mm enhancing mass (arrow) in the posterior, lateral reconstructed left breast. This area was subsequently biopsied under ultrasound guidance with pathology demonstrating invasive carcinoma with ductal and lobular features involving fibro-adipose tissue and skeletal muscle

Mentions: Recurrence may occur locally within the reconstructed breast or in regional lymph nodes. At MR imaging, tumor recurrence following lumpectomy is characterized by a mass with low signal intensity on T1-weighted images, low to intermediate signal intensity on T2-weighted images, and avid and rapid enhancement following administration of gadolinium contrast material (Fig. 11). Other features, such as rim enhancement and spiculated morphology, increase the likelihood of malignancy. If there is an increase in the number or size of axillary or internal mammary lymph nodes, these should be viewed with suspicion for nodal recurrence. Axillary nodal recurrence can occur regardless of whether the initial sentinel node biopsy demonstrated metastatic tumor.Fig. 11


MR imaging of the reconstructed breast: What the radiologist needs to know.

Dialani V, Lai KC, Slanetz PJ - Insights Imaging (2012)

A 57-year-old woman status post left mastectomy and latissimus dorsi myocutaneous flap reconstruction 12 years prior for diffuse DCIS. Enhanced T1W image demonstrates a 7-mm enhancing mass (arrow) in the posterior, lateral reconstructed left breast. This area was subsequently biopsied under ultrasound guidance with pathology demonstrating invasive carcinoma with ductal and lobular features involving fibro-adipose tissue and skeletal muscle
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369124&req=5

Fig11: A 57-year-old woman status post left mastectomy and latissimus dorsi myocutaneous flap reconstruction 12 years prior for diffuse DCIS. Enhanced T1W image demonstrates a 7-mm enhancing mass (arrow) in the posterior, lateral reconstructed left breast. This area was subsequently biopsied under ultrasound guidance with pathology demonstrating invasive carcinoma with ductal and lobular features involving fibro-adipose tissue and skeletal muscle
Mentions: Recurrence may occur locally within the reconstructed breast or in regional lymph nodes. At MR imaging, tumor recurrence following lumpectomy is characterized by a mass with low signal intensity on T1-weighted images, low to intermediate signal intensity on T2-weighted images, and avid and rapid enhancement following administration of gadolinium contrast material (Fig. 11). Other features, such as rim enhancement and spiculated morphology, increase the likelihood of malignancy. If there is an increase in the number or size of axillary or internal mammary lymph nodes, these should be viewed with suspicion for nodal recurrence. Axillary nodal recurrence can occur regardless of whether the initial sentinel node biopsy demonstrated metastatic tumor.Fig. 11

Bottom Line: Surgical management of breast cancer often entails lumpectomy or mastectomy.In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps.Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, C/o Dr. Vandana Dialani, 330 Brookline Avenue, Boston, MA, 02215, USA, vdialani@bidmc.harvard.edu.

ABSTRACT

Objective: The objective is to review the different types of breast reconstruction following cancer surgery and describe expected imaging appearances and complications seen in the reconstructed breast.

Methods: Surgical management of breast cancer often entails lumpectomy or mastectomy. When mastectomy is performed, patients often opt for breast reconstruction. Most facilities do not routinely image the reconstructed breast with mammography.

Results: However, many of these women are imaged with screening breast MRI for evaluation of the contralateral breast, or they may develop a clinical problem that warrants a diagnostic evaluation with MRI. In this article, we will review the more commonly encountered types of breast reconstruction, which include implants, tranversus rectus abdomnis flap, latissimus dorsi flap, deep inferior epigastric perforator flap, and gluteal flaps. Each of these types of reconstruction has different appearances on MR. We will also discuss potential complications that can be seen in the reconstructed breasts, including fat necrosis and recurrence.

Conclusion: Radiologists will better understand the different types of breast reconstruction after mastectomy and their normal imaging appearance on MRI. Radiologists will be more aware of how to recognize complications related to surgery as well as how to determine whether recurrence is present.

Main messages: • The different surgical techniques used in breast reconstruction are discussed. • Describes the normal magnetic resonance imaging appearance of the breast after reconstruction. • Identify MR imaging features of benign sequelae and recurrence following breast reconstruction.

No MeSH data available.


Related in: MedlinePlus